What does each insurance claim response mean?
Responses for all submitted claims can be found in the 'Claims' tab of the patient record, in the 'Request Response' column.
Ack - Digital Response May Follow: This response indicates that the claim has been successfully sent to the insurance company and they may send a further response in the future if they need any further information. (You can use the 'Request for Outstanding Transactions' button to see responses for all claims in one place.)
EOB: Means that the Explanation of Benefits was received with the amount payable from the Insurance (Estimated amount for redetermination).
Ack- Employer Certified Form: Means that the Insurance company requires the Employer to complete an Employment Certification form, please liaise with the patient to have it submitted.
Ack- Rejected: when this response is received, you will need to click on the response to see why this was rejected. Please correct the claim as requested by the insurer and resubmit the claim.
Ack- Manual Submission Required: This means that the insurance company requires a Paper Claim Form to be submitted instead. Simply print the claim forms from the patients 'Claims' tab. Under the 'Action' column, click either download primary or download secondary and then send these off as needed.